Search

TO report the corneal manifestations in patients with COVID-19-associated rhino-orbito-cerebral mucormycosis (ROCM).This study was a retrospective, observational, and record-based analysis of patients of ROCM with corneal involvement.A total of 220 patients were diagnosed with ROCM over a period of 3 months. Thirty-two patients had developed corneal manifestations. The mean age at diagnosis was 52.84 ± 12.8 years. The associated risk factors were systemic mucormycosis, uncontrolled diabetes, recent COVID-19 infection, and injudicious use of systemic steroids. Twenty-nine patients were known diabetics, 32 had recent COVID-19 infection, and 13 gave a history of injudicious use of steroids. The right eye (RE) was affected in nine patients, the left eye (LE) in 20 patients, and both eyes in three patients. Nine patients had a round-oval corneal ulcer. One patient each had a perforated corneal ulcer with uveal prolapse, sealed perforated corneal ulcer, spontaneously healed limbal perforation, diffuse corneal haze with hyphemia, panophthalmitis, diffuse corneal stromal abscess, limbal ischemia, anterior uveitis with posterior synechiae, inferior corneal facet, and filamentary keratitis. Three patients each had a corneal melt and inferior conjunctival xerosis with chemosis. Orbital exenteration was performed in six patients. Five patients with corneal ulcers healed. Topical eye drops of amphotericin (0.5 mg/ml) cycloplegic, antiglaucoma medications, and lubricant eye drops were started along with systemic antifungals.Central corneal ulcer was the most common manifestation of mucormycosis. A concentration as low as 0.5 mg/ml of amphotericin eye drops was effective in the treatment.

Bilateral orbital cellulitis is an uncommon presentation in infants, and its association with rhinosinusitis has been scantily reported in the literature. An infant underwent bilateral uncinectomy and right ethmoidal decompression for bilateral orbital cellulitis with right ethmoidal sinusitis, after a period of non-recovery with conservative treatment. Mixed infection with Escherichia coli and methicillin-sensitive Staphylococcus aureus was observed. The right eyelid swelling began to resolve; however, the left lower eyelid showed an increase in the fluctuant swelling. Transconjunctival incision and drainage of pus was done in the left eye subsequently. The patient showed marked clinical recovery and is doing well. A multidisciplinary management approach can avert potentially life-threatening sequelae of this condition.

Ischaemic optic neuropathy (ION) is a major cause of blindness. The clinical approach and management is a matter of debate for the treating neurologist and the ophthalmologist. Of the two broad varieties namely the posterior (PION) and anterior ischaemic optic neuropathy (AION), the arteritic variety of the AION (AAION) is usually due to giant cell arteritis. Giant cell arteritis may only present with visual loss in up to 25% of cases. AAION is a neuro-ophthalmic emergency. Early recognition and differentiation from AAION is imperative in order to prevent further devastating visual loss. A literature search was conducted on pubmed using key words as AAION, arteritic anterior ischaemic optic neuropathy, giant cell arteritis (GCA) and articles from the year 2000 till date were included. In any case very few reviews are available on AAION. The literature search on pubmed provided holistic overview about this clinical significant entity and the same is compiled in this review. Moreover the histopathologic features of a temporal artery biopsy have been described with its microscopic images. In any case reviews are mostly available on the Non arteritic variety of AION. This review recapitulates the diagnostic and management protocol of a patient presenting with AAION.

Granular cell tumor (GCT) of the oral cavity is rare and so is the involvement of the eye, orbit, and ocular adnexa. A 65-year-old male developed a posttraumatic ulceroproliferative mass over his left cheek for the past 1 year. The mass involved the periorbital region with accompanying blood-stained purulent discharge from multiple sinus tracts over this lesion for the past 6 months. Radiographs of the orbit suggested chronic osteomyelitis. The lesion was not responsive to treatment with antibiotics. Enlarged submandibular lymph node demonstrated reactive lymphadenitis on cytological examination. However, computed tomography scan of the paranasal sinus (PNS) revealed possibly a malignant mass extending into the maxillary sinus and left extraconal space. Surprisingly, histopathological examination and immunohistochemistry from a growth involving the left upper retromolar region that extended up to the midline and periorbital region suggested a diagnosis of GCT. This unusual and new presentation of GCT is not well known to the dentists and also to the ophthalmologists. It is imperative to examine anatomically neighboring structures, especially the eye, nasal cavity, PNSs, and oval cavity among other structures in an underlying pathology in either of these sites.

Rhino-orbito-cerebral-mucormycosis (ROCM) is the most common form of mucormycosis observed during the second wave of COVID-19 where a steep rise in the number of cases was seen. The orbital form is almost always associated with fungal sinusitis. Among the various treatment modalities available, the role of retrobulbar Amphotericin-B injections is under-reported. This study is conducted to determine the role of transcutaneous retrobulbar amphotericin-B (TRAMB) in the management of COVID-19 associated ROCM.a retrospective analysis of 61 patients of COVID-19 associated ROCM was done, who met the inclusion criteria and presented to a tertiary care center, between May to August 2021. These patients were administered TRAMB (deoxycholate/emulsion form) along-with systemic amphotericin B. All the patients were evaluated for clinical improvement.out of 61 patients, 58 (95.08%) showed overall improvement. 40 patients (65.57%) stabilized or improved clinically and 3 patients succumbed to the illness due to advanced systemic mucormycosis and acute kidney failure. Sixteen out of 58 patients underwent orbital exenteration. Out of remaining 43 patients, 35 showed complete recovery of orbital and ocular disease and the disease stabilized in eight patients. Seven patients demonstrated TRAMB associated ocular complications which however completely resolved in six patients.to the best of the author´s knowledge, regression of orbital mucormycosis with improvement in ptosis, proptosis, ocular motility and stabilization of visual acuity are scarcely reported in literature. Further TRAMB as a globe non-deforming treatment modality is an option available for ROCM.

This is a Letter to the Editor and does not have an abstract. Please download the PDF or view the article HTML.

SARS CoV 2 is very much homologous in structure to SARS CoV. Review of literature suggests the in-vitro virucidal action of povidone iodine in SARS CoV and MERS. The oropharynx and nasopharynx are target sites of SARS CoV 2. A significant proportion of COVID 19 sufferers are asymptomatic, but shedding these viral particles, PVP-I has been shown to be a safe therapy when used as a mouthwash or taken nasally or used during ophthalmic surgeries. Aims 1. To propose the use of 0.5% Povidone iodine gargles and nasal drops as prerequisite for office based nose and throat examination and procedures during COVID 19 pandemic. 2. To assess tolerability of 0.5% PVP-I in patients and in healthcare workers. Materials and methods 0.5% PVP-I solution is prepared from commercially available 10% PVP-I solution. Patients were instructed to put 0.5% PVP-I drops in nose and rinse mouth with gargle prior examinations for 30 s. For endoscopic procedure (nasal and throat) nasal douching and gargling to be started one day prior. Douching and rinsing to be repeated just before procedures. Nasal packing with 0.5% PVP-I along with 4% xylocaine/adrenaline solution, tolerability and any allergic reaction noted. Results The patient and health care workers tolerated the 0.5%. No allergy was noted. Conclusion We propose the use of 0.5% PVP-I in healthcare workers and their patients to minimise the risk of spread of the disease in addition to the recommended PPE.

A 32-year-old female presented with a sudden loss of vision in the right eye which she had noticed for one week. A week earlier the patient had presented to a physician with a history of sudden ons...

Amniotic band syndrome is a rare congenital disorder caused by entrapment of fetal parts (usually a limb or digits) in fibrous amniotic bands while in utero that presents with complex multisystem anomalies. The authors report 2 children with amniotic band syndrome who presented to the ophthalmic unit of the authors' pediatric hospital. One of them presented with telecanthus, syndactyly, amputated toes, and unilateral epiphora diagnosed as congenital nasolacrimal duct obstruction. She was managed conservatively with lacrimal sac massage and provided with refractive correction while she simultaneously underwent multiple surgeries for correction of clubfoot and craniosynostosis. The second patient presented with cleft lip, cleft palate, multiple constriction bands in upper limbs and fingers with unilateral microphthalmos, microcornea, typical iris coloboma, and retinochoroidal coloboma, very similar to a case reported in literature. These 2 cases provide an overview of the clinical spectrum of ophthalmic manifestations along with their staged optimum rehabilitation.

Purpose: Leser-Trélat syndrome consists of appearance of a solid tumor-like carcinoma breast, colon, or stomach following eruption of multiple seborrheic keratoses (SK) of the skin. We present an unusual and possibly the first case report of Leser-Trélat syndrome in a male patient with a history of mastectomy for breast carcinoma who presented to us with a second malignancy in the form of basal cell carcinoma (BCC) of the lower eyelid. Procedure: A 75-year-old male presented in 2014 with a history of modified radical mastectomy for infiltrating ductal carcinoma of the left breast which was performed 11 years prior to the day of presentation. Breast carcinoma was diagnosed following eruption of multiple SK at the same time. In the previous 3 years he noted a nodulo-ulcerative growth over the lateral aspect of the right lower eyelid which was clinically diagnosed as BCC. Mass excision under frozen section control and lid reconstruction was performed. Diagnosis of BCC was confirmed on histopathological examination of the excised specimen. Results and Conclusions: Though a previously unobserved entity, our case supports the importance of Leser-Trélat sign and its relevance to affected individuals, as early recognition and prompt treatment of a low-stage cancer offers good prognosis.

Purpose To evaluate performance of different intraocular lenses (IOLs) after cataract surgery in children aged less than 2 years with regards to rates of visual axis opacification (VAO). Methods This was a retrospective chart review of children Results A total of 257 eyes of 159 children were included in the study. The mean age at the time of surgery was 11.63 ± 7.916 months (range 6-23 months). A total of 29 eyes of 16 children underwent phacoaspiration with implantation of SA60 AT (AcrySof, Alcon, Fort Worth, TX); 75 eyes of 45 children received Hoya IOL (Hoya-PS AF-1 Series, Model PC-60AD, Hoya, Japan), 70 eyes of 46 patients received Sensar (Abbott Medical Optics Inc., Santa Ana, CA, USA), and 83 eyes of 52 children received MA60AC (AcrySof). At mean follow-up of 18.31 ± 15.04 months, 22.46% of the patients required resurgery for visual axis obscuration. By multiple regression analysis, the rate of visual axis obscuration was affected by the rate of perioperative complications (p = 0.001) and not affected by age (p = 0.98), type of IOL (p = 0.104), or site of IOL implantation (p = 0.603). Conclusion Our findings suggest comparable rates of VAO for children less than 2 years of age receiving different types of hydrophobic acrylic IOLs.

A database of positional astronomy observations using the Jaiprakas and the Ram Yantra of the Jantar Mantar Observatory in Delhi, is presented here. The purpose of this database is to give an overall idea of the state of the instrument at present, prior to the planned restoration of the instrument surface markings by the Archaeological Survey of India. The observations and the related documentation of procedures involved, are also aimed at providing templates for the planned restoration of the instrument surface markings. The restoration process can utilise the methods outlined here, for the drawing/etching of the markings for the measurements of altitude and azimuth on the one hand, and right ascension and declination (for the Jaiprakas) on the other, using these methods. The time markings along the equator can also be undertaken with the procedures discussed.

Cross-docking is a technique used for scheduling the vehicles in distribution centers more effectively. Cross-Docking Centre (CDC) acts as a temporary distribution center that undergoes three important functions i.e., the goods from inbound trucks are continuously sorted, consolidated and then loaded onto outbound trucks for delivery to the customers. In this paper, an effective Cross-docking framework by considering the different performance measures in inbound and outbound doors has been developed. Subsequently, a multi-objective linear programming model has been developed for optimizing the objectives i.e., minimization of earliness and tardiness for the outbound trucks in a stochastic environment. Moreover, with FLEXSIM based simulation approach the analysis has been conducted and the effectiveness of the proposed framework. Finally, the results are evaluated and validated.

This letter is regarding tackling the highly infectious coronavirus disease (COVID-19).Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread across the globe, causing a worldwide pandemic. The total number of cases across the globe is about 11.6 million with over 5 lakh deaths. The number of individuals detected is always less than the actual number of infected, in nearly all respiratory viral pandemics. Rapid Point-of-Care Antigen detection test can detect SARS-CoV-2 early in the field setting. It has moderate sensitivity and high specificity yet limited availability. This test can be employed in the hospitals and containment zones and would aid in contact tracing, isolation of the affected individuals, localized containment and directing quarantine measures. IgG antibodies usually appear after one week of onset of infection and may last for several months. Serosurveys that detect these antibodies using Enzyme-linked immunosorbent assay (ELISA) help in the assessment of asymptomatic infection in close contacts, enhance the current understanding of the spread of disease, individual’s immune status and in identifying potential plasma donors. Case fatality rate is positively associated with SARS-CoV-2 seroprevalence as was demonstrated in the survey conducted in the Spanish population. Immuno-compromised patients, healthcare workers, relatively young working population comprising of bankers, media persons, individuals working at airports, overseas operations and industries, staff in municipal bodies, shopkeepers, vendors, courier services, telecommunication offices, drivers of hospital ambulances, hearse vans, buses, auto-rickshaw, taxies; bus conductors, farmers, electricity workers, migrant labourers who have travelled back from urban and peri-urban areas to rural/tribal; inhabitants of hard to reach areas, prisoners, densely populated regions of the country as well as natives after coming in contact with returned migrant; police and security personnel, those staying in institutional settings and hostels and inhabitants of containment zones should all be tested for the presence of antibodies against the virus.

Sudden deterioration of visual functions warrants comprehensive ophthalmic examination with evaluation for systemic association. Cerebral venous thrombosis (CVT) is an uncommon disorder that can present with neurological deficits. We report a young female patient aged 28 years who presented with severe headache and sudden diminution of vision and was subsequently diagnosed with hyperthyroidism and CVT. Management of CVT and hyperthyroidism hastened full recovery of visual functions.

An eight-year-old boy presented to our ophthalmology clinic with a four-month history of dry, itchy eyes and a reluctance to play outdoors during late evening, possibly indicating night blindness. The patient’s unaided visual acuity was 6/6 in both eyes. He had triangular, bilaterally symmetric

Before India became an independent country, its scientists and policy makers could foreseethe importance of science in its development, and accordingly a number of research anddevelopment (R&D) institutions were established. However during these five decades ofindependence, the choice between basic sciences and technology was always a subject of debate.It will be appropriate now to examine the changing patterns of Science and Technology (S&T)manpower growth to find out the ground truth reality. The present study pertains to the analysis ofS&T outturn data in various fields of scientific research that can provide a base for S&T planningand policy making. These S&T indicators will be helpful in estimating future requirements, whichin turn can be useful to a great extent in science and technology policy formulation. Theseestimates and future projections are based on mathematical modelling of the data pertaining to theoutturn of highly qualified Scientific and Technical (S&T) personnel in India from differentfaculties over the period 1990-1998. From the trend analysis it is evident that research is no moreperceived as an interesting career except in the field of engineering and medicine. The findingsfurther suggest that there is a noticeable shift from basic sciences to technology.

Extranodal natural killer (NK)/T-cell lymphoma, nasal type (NK/T) is relatively rare, associated with aggressive behavior and poor prognosis. Histopathological findings, immunohistochemical study, and Epstein-Barr virus-encoded ribonucleic acid in situ hybridization are essential for the diagnosis. There are a few case reports in the literature describing the cytological findings of these uncommon lymphomas. We herein describe cytological findings in two cases of extranodal NK/T-cell lymphoma, nasal type presenting as lacrimal gland and/or nasal masses. Fine-needle aspiration smears revealed small to medium-sized lymphoid cells showing irregular nuclear outline, moderate amounts of light basophilic cytoplasm containing fine azurophilic granules in most of the cells. Some of these atypical lymphoid cells showed tongue-like projections of cytoplasm from one or both sides of the cells. Histopathological examination revealed typical angoicentric, angiodestructive growth pattern of these lymphomas.